Violation of vertical balance of the body in children with one-sided high riding trochanter

Abstract

Objective. To study the postural balance disorders in children with a one-sided high riding trochanter, depending on the direction of displacement of the general center of pressure (COP) of the body in the frontal plane.

Material and methods. A two-platform stabilometric study of 16 patients aged 11 to 16 years (M ± m = 13.1 ± 0.76) with a one-sided high riding trochanter of the femur was conducted. The children were divided into two groups: group I – 6 patients with a shift of the general COP  towards the affected lower limb (33[19 – 42] mm), group II – 10 patients with a displacement of the general COP  towards the intact lower limb (17 [8–36] mm). The control group included 16 healthy children of the same age.

Results. Depending on the displacement of the general COP towards the affected or intact lower limb, different values and ratios of stabilometric parameters were observed in patients of both groups individually under each of the contralateral lower limbs. The most pronounced asymmetry of the indicators of the postural balance of the lower extremities compared with the norm was revealed in the second group of patients. Among them, the median difference of sagittal displacement of the COP between the contralateral limbs DY was 45 mm, while in patients of the first group, the median DY was 7 mm. The medians of angular velocities Ω between the lower extremities were correlated as 36 to 23 degrees/s in the second group compared with 27 to 29 degrees/s in the first. Also, in patients of the second group, the highest indicator of excessive quartile deviation of the angle of the direction of oscillations of the vector diagrams α on the affected lower limb was revealed – 62° compared with the intact 11°.

Conclusions. Significant asymmetry of postural balance indicators in patients of the second group may be due to compensatory reactions of the body to prevent gross destabilization of the entire postural control system, therefore, such an imbalance corresponds to an adequate postural strategy.

Keywords

high riding trochanter / biomechanics / bilateral stabilographic test / frontal and sagittal balance

References

[1] Pozdnikin I.Yu., Baskov V.E., Barsukov D.B., Bortulev P.I., Krasnov A.I. Relative over-growth of the greater trochanter and trochanteric-pelvic impingement syndrome in children: causes and x-ray anatomical characteristics. Pediatric Traumatology, Orthopaedics and Reconstructive Surgery 2019; 7 (3): 15–24 (in Russian).

[2] Поздникин И.Ю., Басков В.Е., Барсуков Д.Б., Бортулёв П.И., Краснов А.И. Гипертрофия большого вертела и вертельно тазовый импинджмент-синдром у детей (причины формирования, рентгеноанатомическая характеристика). Ортопедия, травматология и восстановительная хирургия детского возраста 2019; 7 (3): 15–24.

[3] Albers C.E., Steppacher S.D., Schwab J.M., Tannast M., Siebenrock K.A. Relative femoral neck lengthening improves pain and hip function in proximal femoral deformities with a highriding trochanter. Clin Orthop Relat Res. 2015; 473 (4): 1378–1387.

[4] Pozdnikin I.Yu., Bortulev P.I., Barsukov D.B., Baskov V.E. Transposition of the great trochanter: A look at the problem. Pediatric Traumatology, Orthopaedics and Reconstructive Surgery 2021; 9 (2): 195–202 (in Russian).

[5] Поздникин И.Ю., Бортулёв П.И., Барсуков Д.Б., Басков В.Е. Транспозиция большого вертела. Взгляд на проблему. Ортопедия, травматология и восстановительная хирургия детского возраста 2021; 9 (2): 195–202.

[6] Pereiro-Buceta H., Becerro-de-Bengoa-Vallejo R., Losa-Iglesias M.E., López-López D., Navarro-Flores E., Martínez-Jiménez E.M., Martiniano J., Calvo-Lobo C. The Effect of Simulated Leg-Length Discrepancy on the Dynamic Parameters of the Feet during Gait-Cross-Sectional Research. Healthcare 2021; 9 (8): 932.

[7] Kazennikov O.V., Kireeva T.B., Shlykov V.Y. Influence of structure of the support surface under the sole on vertical posture during standing with different body weight distribution between legs. Human Physiology 2016; 42 (4): 61–68 (in Rus-sian).

[8] Казенников О.В., Киреева Т.Б., Шлыков В.Ю. Влияние структуры опорной поверхности под стопой на поддержание вертикальной позы при разном распределении нагрузки между ногами. Физиология человека 2016; 42 (4): 61–68.

[9] Assogba T.F., Boulet S., Detrembleur C., Mahaudens P. The effects of real and artificial leg length discrepancy on mechanical work and energy cost during the gait. Gait & Posture 2018; 59: 147–151.

[10] Assogba T.F., Boulet S., Detrembleur C., Mahaudens P. The effects of real and artificial leg length discrepancy on mechanical work and energy cost during the gait. Gait Posture 2018; 59: 147–151.

[11] Schekolova N.B., Likhacheva L.V. Dynamics of biomechanical and electromyo-graphic changes in conservative treatment of children with idiopathic low limb shortening. Perm Medical Journal 2013; 30 (1): 73–78 (in Russian).

[12] Щеколова Н.Б., Лихачева Л.В. Динамика биомеханических и электромиографических изменений при консервативном лечении детей с идиопатическим укорочением нижних конечностей. Пермский медицинский журнал 2013; 30 (1): 73–88.

[13] Bangerter C., Romkes J., Lorenzetti S., Krieg A.H., Hasler C.C., Brunner R., Schmid S. What are the biomechanical consequences of a structural leg length discrepancy on the adolescent spine during walking? Gait & Posture 2019; 68: 506–513.

[14] Tannast M., Hanke M., Ecker T.M., Murphy S.B., Albers C.E., Puls M. LCPD: reduced range of motion resulting from extra- and intraarticular impingement. Clin Orthop Relat Res. 2012; 470: 2431–2440.

[15] Lu H.L., Lu T.W., Lin H.C., Hsieh H.J., Chan W.P. Effects of belt speed on the body's center of mass motion relative to the center of pressure during treadmill walking. Gait Posture 2017; 51: 109–115.

[16] Vieira M.F., de Brito A.A. Junior, Lehnen G.C., Rodrigues F.B. Center of pressure and center of mass behavior during gait initiation on inclined surfaces: A statistical parametric mapping analysis. J Biomech. 2017; 3 (56): 10–18.

[17] Schorderet C., Hilfiker R., Allet L. The role of the dominant leg while assessing balance performance. A systematic review and meta-analysis. Gait Posture 2021; 84: 66–78.

[18] Kim S.B., Lee G.S., Won Y.G., Jun J.B., Hwang C.M., Hong C.H. Radiologic findings of pelvic parameters related to sagit-tal balance. J. Korean Soc. Spine Surg. 2016; 23 (3): 197–205.

[19] Kim S.B., Lee G.S., Won Y.G., Jun J.B., Hwang C.M., Hong C.H. Radiologic findings of pelvic parameters related to sagittal balance. J. Korean Soc. Spine Surg. 2016; 23 (3): 197–205.

[20] Dotsenko V.I., Usachev V.I., Morozova S.V., Skedina M.A. Modern algorithms of postural disturbances in clinical practice. Meditsinskiy sovet 2017; 8: 116–122 (in Russian).

[21] Доценко В.И., Усачев В.И., Морозова С.В., Скедина М.А. Современные алгоритмы стабилометрической диагностики постуральных нарушений в клинической практике. Медицинский совет 2017; 8: 116–122.

Funding

Правительство РФGovernment of the Russian Federation

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